| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | DELTA DENTAL OF COLORADO | $4K | — | $4K | 8.02% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY INC | 7351 E LOWRY BLVD STE 400 DENVER, CO 80230 | DELTA DENTAL OF COLORADO | $892 | — | $892 | 2.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 95113 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 13.18% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK E DRIVE STE 350 BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $54 | $54 | 0.22% |
| CARLA CHARLEY3 | 62371 RABBIT TRL MONTROSE, CO 81403 | AFLAC | $468 | $98 | $566 | 3.14% |
| DEANNA HEIDI SWETNAM3 | 670 35 RD CLIFTON, CO 81520 | AFLAC | $280 | — | $280 | 1.55% |
| JO ANNE ALLEN LLC3 | 6110 LAGOLONDRINA CT WHITEWATER, CO 81527 | AFLAC | $270 | — | $270 | 1.50% |
| MYWHY LLC3 | PO BOX 276 WHITEWATER, CO 81527 | AFLAC | $170 | $28 | $198 | 1.10% |
| AMY M BUCHANAN3 | 348 SIR CHANDLER DR KILL DEVIL HILLS, NC 27948 | AFLAC | $133 | $25 | $158 | 0.88% |
| JUSTIN ALLEN PHILLIPS3 | 66107 COTTONWOOD DR MONTROSE, CO 81403 | AFLAC | $118 | — | $118 | 0.66% |
| NICHOLE MARIE LEMUS-SUAREZ3 | 2530 LOCUST RD MONTROSE, CO 81401 | AFLAC | $64 | $30 | $94 | 0.52% |
| JO ANNE ALLEN LLC3 Filed as: JO ANNE ALLEN-SLEE | 6110 LAGOLONDRINA CT WHITEWATER, CO 81527 | AFLAC | $77 | — | $77 | 0.43% |
| DEBRA STAYNER3 | 231 HOWARD FORK AVE MONTROSE, CO 81403 | AFLAC | $73 | — | $73 | 0.41% |
| MANUEL A MADRID3 | 4624 141ST LANE NE HAM LAKE, MN 55304 | AFLAC | $60 | — | $60 | 0.33% |
| MORGAN CRYSTAL IVIE3 | 30693 HERMAND RD OLATHE, CO 81425 | AFLAC | $50 | — | $50 | 0.28% |
| JEFFREY K HAWKINS3 | 2300 MAJOR LN MONTROSE, CO 81401 | AFLAC | $46 | — | $46 | 0.26% |
| MOUNTAIN WEST INS & FIN SVCS, LLC3 Filed as: MOUNTAIN WEST INS & FIN SVCS LLC | 100 E VICTORY WAY CRAIG, CO 81625 | AFLAC | $45 | — | $45 | 0.25% |
| CYNTHIA MYER3 | 26005 COLONY DR SALVO, NC 27972 | AFLAC | $32 | — | $32 | 0.18% |
| ASPEN R LLC3 Filed as: ASPEN R MADRID | 261 MONARCH CREST TRL DURANGO, CO 81301 | AFLAC | $30 | — | $30 | 0.17% |
| DAWN STANDISH3 | 2013 ARROW RD DELTA, CO 81416 | AFLAC | $26 | — | $26 | 0.14% |
| BEVERLY J GARRETSON3 | 21446 UNCOMPAHGRE RD MONTROSE, CO 81403 | AFLAC | $25 | — | $25 | 0.14% |
| CHRISTOPHER WALLACE HOFF3 Filed as: CHRISTOPHER HOFF PROF LLC | 56 MARATHON KEY WAY PONTE VEDRA, FL 32081 | AFLAC | $20 | — | $20 | 0.11% |
| JUDITH J ROSEBERRY3 | 3439 N 164TH AVE GOODYEAR, AZ 85395 | AFLAC | $18 | — | $18 | 0.10% |
| JONATHAN SAMUEL KIRKLAND3 | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $17 | — | $17 | 0.09% |
| REX SWANSON3 Filed as: REX A SWANSON | 1035 MARGO CT APT A MONTROSE, CO 81401 | AFLAC | $14 | — | $14 | 0.08% |
| JOSE DE LOS SANTOS III3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $5 | — | $5 | 0.03% |
| TINA WAY3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $4 | — | $4 | 0.02% |
| ANNETTE S WULFF3 | 471 E SCENIC DR GRAND JUNCTION, CO 81507 | AFLAC | $4 | — | $4 | 0.02% |
| JOHN P THOMPSON3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $3 | — | $3 | 0.02% |
| KIEFER GROUP INSURANCE AGCY LLC3 | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80112 | AFLAC | $2 | — | $2 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 160 W SANTA CLARA ST STE 675 CINCINNATI, OH 452632886 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.15% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK E DRIVE STE 350 BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $72 | $72 | 0.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $957 | — | $957 | 10.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $344 | — | $344 | 14.55% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK E DRIVE STE 350 BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6 | $6 | 0.25% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 951131700 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $307 | — | $307 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $38K |
| TRIAD RESOURCE GROUP EAP PROVIDER | Other services Service code 49 | 4350 NORTH LOWELL AVE CHICAGO, IL 60641 | $5K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 82 | $44K |
| Vision | VISION SERVICE PLAN | 45 | $10K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $4K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 108 | $29K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $25K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.